Gum health. Gingivitis and Periodontitis
The gingivitis and the periodontitis are forms of periodontal disease. Affect a large portion of the population. And consist in the inflammation of the gums and the surrounding tissue that covers the teeth, the inflammation is caused by the bacteria in the dental plaque. It may occur without bone destruction (gingivitis) or with the damage of the jaw bones (Periodontitis).If neither of this conditions is treated it could end in dentition loss.
These diseases have their origin in the accumulation of dental plaque and it’s bacteria under the gums. Bad dental higiene, hormonal changes, smoking, some sistemic diseases or bad aligned teeth are factors that may increase the possibility of suffering gingivitis.
The treatment for regular gingivitis is the deletion of the dental plaque deposits in the gums. However, this may not be enough to actually control de disease, especially if this procedure is carried out by unexpert hands or in a hurry way.
In the Padrós Dental Clinic (Clínica Dental) We care to promote and apply the right treatment for every case. Besides performing a complete dental cleaning and eliminate in a carefully way every dental plaque deposit in the mouth, it’s usually convenient to do a culture of this gingivitis-provoking germs to treat every case according to its requirements, carry out antibacterial irrigations, polish the toothpaste and avoid situations that favor the problem ( Bad aligned teeth, food remains between them, etc…)
Finally, it’s necessary to stimulate the joining of the gum with the tooth to achieve a good closure within them, thus closing the door to new gingivitis to appear. All of it must be made under control with regular exams and graphic periodontograms that measure the quality of the closings around the teeth.
Depending on the case, we have very advanced treatments such as laser treatment, microscopic analysis and bacterial cultures, photodynamic therapy, regenerative treatments and microsurgery, as well as gum coverage with the pinhole technique or v.i.s.t.a..
Treatment of inflamed gums (gingivitis-periodontitis-peri-implantitis).
- Periodontogram: In order to know the state of the gums, have a good diagnosis and be able to prepare an appropriate treatment plan, we must first analyze their condition. In this way we will know, objectively, how they are at the present moment.To do this, with the help of the computer and the Florida Probe® system, we created a map that shows the state of the gums around each tooth (6 evaluation points for each tooth). Based on what we see on that map, and following our protocols based on scientific evidence, we program the appropriate treatment for each case. The periodontogram will also serve to verify, objectively, whether we have managed to completely cure the gum problem at the end of treatment, and will also allow us to monitor its evolution over time, during regular maintenance and check-ups. In this way, we can fully control the state of the gums and we can keep them healthy throughout life.
- Cleaning with ultrasound and manual curettage: Guided by the gum map and radiographs, and in expert hands, we make sure first of all to eliminate all the bacterial plaque and tartar present, not only in the visible area of the teeth , but also under the gums and in the hidden zones where access is more difficult. This first step is essential to start the recovery, but we have to go further.
- Bacterial culture and microscopic control: We all have bacteria in our mouths, but there are many different varieties, and some are more aggressive than others. The most neglected mouths often contain anaerobic species of bacteria and even amoebae, which produce a lot of inflammation and destruction of the supporting bone of the teeth. In case of identifying this type of microorganisms, we must eliminate them to ensure that the oral flora is replenished with healthier bacteria. For this we use irrigation systems under the gums, application of bioadhesive gels of topical antibiotics or sometimes systemic antibiotics for a few days.
- Elimination of inflammatory epithelial tissue from the inner part of the gums: Explained schematically, the gums have two layers. The inner layer is made up of connective tissue, which allows it to attach to the jaw bone and teeth. The outer layer is covered by epithelial tissue, which serves to protect against food rubbing, chemicals, bacteria, brushing, etc. When tartar accumulates under the gums, the epithelial tissue grows inside the gingival sulcus to defend against irritation caused by bacteria. For this reason, if we simply carry out a conventional cleaning once a year, we cannot solve the problem or stop periodontal disease, since, even if we can eliminate tartar, the gums cannot re-adhere to the tooth, leaving some space (a "periodontal pocket") under the gums, where in a short time bacterial plaque and tartar accumulates again. Formerly, to remove this layer of internal epithelial tissue, it was necessary to undergo surgery. Today it is not necessary. The solution is much simpler and more comfortable for the patient, and we can achieve it by applying irrigations under the gums, which do not generate the slightest discomfort and let us achieve the same results.
- Laser Treatment: Modern lasers allow us to eliminate all the bacteria inside the periodontal pockets (under the gums). They also allow us to destroy inflammatory tissue and can be used to regenerate bone in a minimally invasive way, without having to undergo any surgery.
- Periodontal and regenerative surgeries: Although we try to avoid having to perform any surgery, in the most severe cases it may be necessary to do it in order to solve the problem. There are many surgical techniques that allow us to treat advanced gum problems. Often we can not only cure the gum disease that is present, but we can also regenerate locally the lost bone using guided bone regeneration techniques. grafts, the use of growth factors, synthetic enamel proteins, etc.
- Teaching oral hygiene and maintenance: Once periodontal disease is cured, it is very easy to keep gums healthy by following our maintenance plans and regular control check ups. Teaching and motivating oral hygiene techniques at home is a very important part of the treatment.
With the correct follow-up, we can keep the gums under control throughout your whole life.
The result of the integral gingivitis treatment must be controlled by graphics that measure the quality of the closure in the gums around the teeth (periodontogram).
Frequently asked questions about gingivitis and periodontitis.
What is the gingivitis?
Also known as “Gum disease” it’s an infection of the tissue that surrounds the teeth and it’s a common cause for the loss of them.
How common is it?
Very common. Seven of ten People tend to suffer it at some point of their life. It’s the most common dental problem and it could get a long way without pain, until it becomes a real issue. That’s the reason why it is so important to prevent it before it turns into a severe condition.
How does it start? What are the causes of the gingivitis?
The gum disease begins when the dental plaque sticks itself on to the visible border of the gum. If the plaque doesn’t get removed everyday through the teeth brushing and the use of dental floss, the dental plaque hardens until it becomes tartar. This tartar allows a bacterial infection to grow in the unions of the gum. In these first stages, the disease is more known as gingivitis.
The gums, turn into a red tone, but you may not notice it at all. As the gingivitis gets worst, little infections in the cavities start to appear. The gums could inflammate then, and the bleeding when brushing your teeth may occur, but without pain. As the time goes by, the infection obliterates the tissue and you may be on risk of losing one or more dental pieces.
What increases the chances of suffering it?
- Smoking or chewing tobacco.
- Certain medicines.
- Dentures that no longer fit correctly and create cavities where the dental plaque has the opportunity to grow.
Which are the signs and symptoms?
- Sensitive gums, the inflammation of these with a red coloration and a tendency to bleed during the teeth brushing. Encías que se han separado de los dientes
- Bad breath or persistent tastelessness.
- Teeth movement or a change in your bite.
- A change in how your upper and lower teeth adjust.
Are there different kinds?
Yes, the gingivitis is the mild form of it and it’s very reversible. This condition could be treated with an enhancement in the dental care, such as: increasing the amount and quality of teeth brushing, the use of dental floss, the use of mouthwash and regular visits to the Dental Clinic.
The periodontitis is a severe version of gingivitis that can lead to the losing of your teeth.
How is it diagnosed?
Your dentist will check your teeth using a periodontal probe in each one of you visits. Also it can be determined through dental X- rays.
How can I prevent it to happen?
The prevention is the most important factor when fighting the gum disease. It is essential to keep your teeth and gums clean. Brushing your teeth at least twice a day and using dental floss at least once every 24 hours will make it with the right use of both, clearly. This way, you’ll manage to have a good Oral Hygiene and prevent the apparition of the dental plaque which is the main place where the gingivitis-provoking bacteria tend to live.
Make sure to visit you dentist on a regular basis so you get professional exams and dental care, this way, he or she can detect any early sign of gum disease and provide the right Treatment.
How can I know if I’m brushing or using the dental floss correctly?
The teeth brushing: You must brush your teeth with care, giving special attention to the union areas between the gum and the teeth. You must clean the whole tooth surface. Use the tip of the brush to clean behind the upper and lower frontal teeth.
The dental floss: Take a piece of floss of around 30 cm long and wrap it up around your middle fingers. Using a clean section of the floss every time, wrap your tooth with the floss in a C form, slide the floss up and down through the whole surface of the tooth a couple of times. Repeat on each tooth.
What happens if I’m already in the first stages?
If that’s the case, the dental plaque and tartar elimination gives you gums a chance to get better. That’s why, in the first stages of the gum disease, the best treatment is:
- Dental cleansing by your dentist so the tartar gets removed, brushing your teeth twice a day and the usage of dental floss once a day to eliminate the dental plaque.
- When the disease is in a more advanced and serious stage, you should look for a Periodontics specialized Dentist. A Periodontist has at least 3 years of additional college formation in the treatment of the gum disease and in the restauration(or regeneration) of the bone tissue that has been lost due the periodontitis.